CBS 2019
CBSMD教育中心
中 文

Acute Coronary Syndrom

Abstract

Recommended Article

Long-term outcomes after myocardial infarction in middle-aged and older patients with congenital heart disease-a nationwide study Invasive Versus Medical Management in Patients With Prior Coronary Artery Bypass Surgery With a Non-ST Segment Elevation Acute Coronary Syndrome: A Pilot Randomized Controlled Trial BMI, Infarct Size, and Clinical Outcomes Following Primary PCI Patient-Level Analysis From 6 Randomized Trials Effect of alirocumab on major adverse cardiovascular events according to renal function in patients with a recent acute coronary syndrome: prespecified analysis from the ODYSSEY OUTCOMES randomized clinical trial Effect of Medication Co-payment Vouchers on P2Y12 Inhibitor Use and Major Adverse Cardiovascular Events Among Patients With Myocardial Infarction: The ARTEMIS Randomized Clinical Trial Spontaneous Coronary Artery Dissection: Current State of the Science: A Scientific Statement From the American Heart Association Acute Noncardiac Organ Failure in Acute Myocardial Infarction With Cardiogenic Shock The (R)Evolution of the CICU - Better for the Patient, Better for Education
|<<... 17 18 19 20 21 22 23 ...>>|

Clinical Trial2018 Feb 6;71(5):499-509.

JOURNAL：J Am Coll Cardiol. Article Link

Effect of Plaque Burden and Morphology on Myocardial Blood Flow and Fractional Flow Reserve

Driessen RS, Stuijfzand WJ, Knaapen P et al. Keywords: coronary artery disease; coronary computed tomography angiography; fractional flow reserve; myocardial perfusion; plaque; positron emission tomography

ABSTRACT

BACKGROUND - Atherosclerotic plaque characteristics may affect downstream myocardial perfusion, as well as coronary lesion severity.


OBJECTIVES - This study sought to evaluate the association between quantitative plaque burden and plaque morphology obtained using coronary computed tomography angiography (CTA) and quantitative myocardial perfusion obtained using [15O]H2O positron emission tomography (PET), as well as fractional flow reserve (FFR) derived invasively.


METHODS - Two hundred eight patients (63% men; age 58 ± 8.7 years) with suspected coronary artery disease were prospectively included. All patients underwent 256-slice coronary CTA, [15O]H2O PET, and invasive FFR measurements. Coronary CTA-derived plaque burden and morphology were assessed using commercially available software and compared with PET perfusion and FFR.

RESULTS - Atherosclerotic plaques were present in 179 patients (86%) and 415 of 610 (68%) evaluable coronary arteries. On a per-vessel basis, traditional coronary plaque burden indexes, such as plaque length and volume, minimal lumen area, and stenosis percentage, were significantly associated with impaired hyperemic myocardial blood flow (MBF) and FFR. In addition, morphological features, such as partially calcified plaques, positive remodeling (PR), and low attenuation plaque, displayed a negative impact on hyperemic MBF and FFR. Multivariable analysis revealed that the morphological feature of PR was independently related to impaired hyperemic MBF as well as an unfavorable FFR (p = 0.004 and p = 0.007, respectively), next to stenosis percentage (p = 0.001 and p < 0.001, respectively) and noncalcified plaque volume (p < 0.001 and p = 0.010, respectively).

CONCLUSIONS - PR and noncalcified plaque volume are associated with detrimental downstream hyperemic myocardial perfusion and FFR, independent of lesion severity.

Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
>CBS CBS 2019

> CBS 2019 REGISTRATION

> CBS 2019 PROGRAM

> CBS 2019 CALL FOR SCIENCE

> CBS 2019 SPOTLIGHTS

 CBSMD

> CBSMD WEBSITE REGISTRATION

> EDUCATION CENTER

> RECOMMANDED PAPER

> TOP 10 RESEARCH PAPER

> PRE-READING

CBS 2019 CBS 2019 FACULTY Education Resource CBSMD Scientific Library
Copyright ⓒ CBS MD Nanjing China. All rights reserved. 京ICP备16025898号-11
联系我们| Top